PACS:
1. n. (acronym)Picture Archiving and Communications System. A device or group of devices and associated network components designed to store and retrieve medical images.
2. n. (acronym)Pain And Constant Suffering.

Saturday, August 02, 2008

I'm just back from Boston, having spent the past several days holed up with the developers of Amicas' latest and greatest, Version 6, or V6 for short. This was a lot more fun than you might think, as these are not only brilliant folks, but they are also some of the nicest and most down-to-earth people I know. They welcomed me and Mrs. Dalai (who was not amused by her title) to Amicas' world-wide headquarters (which is in the New Balance building by chance) and made us feel right at home.

I had the chance to simulate my workday sitting in front of a V6 workstation. As an added bonus, we were using one of the new Barco 6MP color monitors. I want one, although the $17K price tag will keep it out of my reach for a while.

HQ is a maze of cubbies and computers, much like any of the dot.coms in their heyday. There is no impending sale of the company, thank you, and work proceeds nicely on several fronts.

I cannot post any specifics on V6 at the moment, but your patience will be rewarded before too long. I will go out on a limb and tell you that its code name is "Phoenix", which is a bit of hyperbole based on the fact that this is one of a very few PACS products that has been completely rewritten from the ground up. Since its predecessors are still functioning well, the imagery of "rising from the ashes" is a little overblown. When I first saw the initial stub-laden pre-alpha version, I commented that it should be called "Freedom PACS" as in freedom from the way other big companies do things. That hasn't caught on as yet, but I keep hoping for a change of heart, and a chance at residuals for coining the name.

Since I can't tell you much about V6, I am left with telling you what it doesn't do (obviously stuff that can be found on some competing products):

V6 doesn't have an unstable worklist

It doesn't allow two people to be dictating the same study at the same time.

It won't show the demographics for the last patient you were looking at for 20 seconds or so while displaying the images for the next.

It will not show you the wrong report associated with the prior study you are viewing.

It will not randomly choose a prior to show you even after you have clicked the one you do want.

It doesn't have a hanging protocol setup so badly done that you don't bother using it.

V6 doesn't make you wait for everything in the worklist to be cached before it lets you start viewing an image.

It will not mistake "relevance" for "relevants"

It will not limit me to one viewport for one series, and float the series selectors over the viewing real-estate.

It will not utilize "toggling".

It will not treat examinations of the same patient from different campuses of the same hospital system as coming from entirely different patients, thus impairing comparison.

It will not hide functions in unexpected places.

It will not be confused as to how a three-dimensional cursor should operate.

It will not assume that changes (like windowing) to one slice of a CT or MR should not propagate to the rest of the series.

It will not erase the search-term you last used when you click in the text-window.

It does not make you open a study to see if someone else is reading it.

It will not display a study that was on your worklist when you first started reading, but has since been dictated.

It will not restrict you to six measurements per slice or image.

It does not make you buy another client and separate program to run via the web.

V6 will not be integrating someone else's software into an older version of itself to form any sort of hybrid product.

It will not require additional (extra cost) software to display MPR's or VR's.

It will not automatically change the parameters of a search from "all times" to "Last 7 Days".

It will not restrict you to placing a series in one and only one viewport.

It will not force you to use clone windows.

It will not make extensive use of toggling.

It will not promise individual functions (pre-cans, worklists, etc.) that somehow become system-wide and not individual at all.

It will not randomly change column-widths and sorting parameters and such.

It will not carry through old ideas that didn't work for anyone except for a select few members of a very focused focus group.

It was not created by letting the inmates run the asylum (thank you Alan Cooper!)

V6 will show the industry how PACS should work. As with Amicas' previous offerings, it will not be perfect, but it is pretty darn good. Trust me on that.